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Leadership vacuum at DoH

MJ Blancaflor

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Local doctors and scientists at the frontline of the battle against the coronavirus disease 2019 (COVID-19) pounced on the leadership at the Department of Health (DoH) for the agency’s poor handling of coronavirus data and its lack of “clear, cohesive, and transparent” communication campaign to address the surge of virus cases.

A medical expert and special adviser to the National Task Force on COVID-19 has expressed disappointment at the DoH in the release of confusing daily figures.

In a tweet posted Saturday, Dr. Tony Leachon noted that the public seeks accountability from the DoH as the agency continues to report COVID-19 infections that include part of its validation backlog which were classified as “late” cases.

“Forgive me, I think the lead agency has lost focus in everything. Risk communication, priorities, data management and execution of all plans,” he wrote in his tweet.

His remarks came after the D0H recorded 607 additional cases on Saturday — raising the nationwide total to 25,392 — higher than the estimated 24,000 cases by mid-June as projected by statisticians from the University of the Philippines.

Leachon lamented the DoH’s “lack of sense of urgency” in managing data which has been a crucial basis of government‘s policies amid the health crisis.

President Rodrigo Duterte is considering three options for the new quarantine classification to be implemented over Metro Manila and Cebu City.

Presidential spokesman Harry Roque said Duterte could retain the general community quarantine (GCQ) classification in both areas, place them in the least strict modified GCQ (MGCQ), or return them to the more strict modified enhanced community quarantine (MECQ).

“It would be up to the President because we are balancing the economy and enough capacity to provide medical care for critical patients,” he said.

Utter frustration

“I’m frustrated with the lack of sense of urgency of the DoH leadership in data management,” Leachon, however, said.

“Without a clear, cohesive and transparent communication from the DoH, the noise from an overly-stressed out and highly-emotional public, interposed with a varied mixture of political opinions and even potentially-misleading facts, will sadly just drown out the truth,” the physician added.

A group called the Scientists Unite Against COVID-19, which describes itself as a monitor of the government’s response to the pandemic, also urged the DoH to address its case of validation delays and testing backlogs.

The group found out in its analysis that coronavirus laboratory testing had a median turnaround time of three days and only about one-third of results were released within two days of sample receipt. Meanwhile, the group’s analysis also showed that case validation had a median time of three days.

“The significant delay in case confirmation has implications for other crucial public health interventions such as contact tracing and local policy decisions,” the group said.

The group, however, clarified that their analysis was not peer-reviewed.

The department has previously assured the public that it had taken steps to address these issues, such as digitizing its data monitoring system.

“COVID-19 surveillance in the Philippines is hampered by insufficient capacities for laboratory testing and case validation, giving rise to two distinct and related backlogs. The delays brought about by these backlogs carry significant implications for policy and public information,” the group explained.

Deaths decreasing

The DoH has yet to respond to Leachon’s remarks, but the agency reported in a televised briefing on Sunday that COVID-19 fatalities in the Philippines have been decreasing since the end of April based on the actual date of deaths.

DoH Undersecretary Maria Rosario Vergeire said the current case fatality rate in the country stands at 4.24 percent as of 13 June, which was lower than the local figure on 31 May and the global fatality rate of 5.6 percent. The nationwide death toll stands at 1,074 as of 13 June.

Median deaths remain low at nine cases per day, she added.

Dr. John Wong, an epidemiologist and a member of the data analytics technical working group of the Inter-Agency Task Force on the Management of Infectious Diseases, said that the DoH’s reporting of fatalities has also improved.

There used to be a 22-day delay between the death of a COVID-19 patient and the DoH’s reporting, but there is only a seven-day delay at the present, he added.

Vergeire owes up

Vergeire reiterated that if a COVID-19 patient dies, the DoH does not automatically include the individual in its official tally. The agency’s Epidemiology Bureau has to validate if the real cause of the person’s death is COVID-19 which takes time.

“The reports of deaths will come from local government units. Once the report reaches our office or the DoH, we need to validate the cause of death if it’s really COVID-19, including other information or details from the patient,” she said.

Vergeire also clarified that the 22 coronavirus-related deaths reported in 13 June did not occur on that day.

“Among the 22 fatalities that we reported yesterday, only four of them died in June… The other patients died in the previous months but were only submitted in our Epidemiology Bureau recently that’s why we only reported it now,” she said.

“Allow us to apologize if you were alarmed over these numbers. As we repeatedly emphasize, these numbers were based on when the death was reported to the public. Not on the day the patients have died,” Vergeire added.

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